Patient Info

Initial Consultation

At your initial complimentary consultation, our goal is to provide you with every detail related to your orthodontic treatment – the what, how long, and how much.

You will meet with the Treatment Coordinator who will be by your side through every step. She will provide you with a tour of the office, review your medical history, and take complete records (photos and X-rays, as needed). Dr. Lee will complete a physical evaluation and determine if treatment is recommended, and if so, what type (Phase I, metal/ clear braces/ Invisalign), and how long the treatment will take. Dr. Lee is very careful to fully explain the treatment plan and answer any questions you may have regarding your treatment.

Once the evaluation is complete, the Treatment Coordinator will help you find the best financial plan that fits your family’s budget and discuss any applicable orthodontic, insurance benefits. She will also review the treatment plan with you to make sure there are no further questions.

The initial consultation takes about an hour. When you leave, you will know exactly what treatment is recommended for your specific needs; how long the treatment will take; what kind of investment you can expect, and what payment options are available.

Our goal is to make sure you have no unanswered questions and are confident in your treatment plan.

Privacy & Security

All your information is transmitted and stored securely with 256-bit SSL encryption.

New Patient Forms

Step 1 of 5

Please fill this form out and submit it prior to your first consultation.
For your convenience, our New Patient Forms are completely electronic – no need to print and bring in any paperwork!
Please have your dental insurance information on hand. By providing your dental insurance information, we are able to pre-determine any orthodontic benefits prior to your initial consultation. This information will allow us to provide you a more accurate accounting of what your out-of-pocket, orthodontic investment will be.
This form is expected to take 15-20 minutes to complete.

Patient's Name*
First Last
Name Patient Prefers To Be Called
Patient's Date of Birth*
MM slash DD slash YYYY
Patient's Sex*
- Male
- Female
Patient's Home Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Parent/Guardian Name
First Last
If applicable.
Parent/Guardian Home Phone
Patient's School
If applicable.
Patient's Sports/Hobbies
How did you hear about us?

Patient Info

Initial Consultation

Privacy & Security

New Patient Forms

Step 1 of 5

Primary Insurance

Secondary Insurance

General Health History

Please answer yes or no to the following:

General Dental History

Please indicate yes or not to the questions below:

Acknowledgment

Our Location

Address

Phone

Email

Areas We Serve

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Discover Why Age 7 is So Important for Your Kid’s First Orthodontic Appointment!